胎儿右室双出口的超声诊断

摘要

Objective To provide more imformation for clinical therapy of fetal double outlet in right ventricle(DORV) by studying the echocardiographic feature,associated anomalies and accurate prenatal diagnosis.Methods 18 fetuses with DORV in our hospital were reviewed in the past six years.The fetal echocardiographic findings were compared to postnatal findings by transthoracic echocardigraphy or surgery or autopsy.Results (1)Among the 18 fetuses with DORV,there were 12 simple-type cases and 6 complicated-type cases,whose accurate diagnosis of antenatal sonography were 8 cases(8/12) and 4 cases(4/6) respectively.(2)7 DORV fetuses with outflow obstruction,4 cases with left ventricle dysplasia and 15 cases with severe extracardiac abnormality were accurately diagnosed by prenatal ultrasonography,whose accurate diagnosis compared with post partum were 7 cases(7/7),4 cases(4/4)and 12 cases(12/15) respectively.(3)The causes of prenatal missed diagnosis and misdiagnosis were analyzed.Conclusions In most cases careful evaluation by fetal echocardiography can accurately diagnose DORV and determine essential anatomic details in fetuses with DORV as well as provide enough accurate information for appropriate prenatal consultation and postnatal management.%目的 了解右室双出口(DORV)胎儿的超声心动图特征、相关畸形以及产前诊断的准确性,为DORV胎儿的临床处置提供信息.方法 复习了我院6年间18例胎儿DORV的声像图特点,所有病例经产后超声心动图或外科手术或尸检证实,并与产前胎儿超声心动图的结果进行比较.结果 (1)18例胎儿DORV中,简单型12例,产前超声正确诊断8例(8/12);复杂型6例,产前超声正确诊断4例(4/6);(2)产前超声诊断胎儿DORV合并主要的解剖学病变包括流出道梗阻病变7例,左心室发育不良4例,严重心外畸形15例次,与产后结果比较其正确诊断分别为7例(7/7),4例(4/4)和12例(12/15);(3)对产前漏误诊的原因进行分析.结论 胎儿超声心动图能较准确地诊断DORV,确定其形态学特征,可为DORV胎儿父母提供合适的产前咨询和产后处理的信息.